WSJ: Home Health Care Booming, But Leaving Workers Behind

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Home health care is among the fastest-growing sectors in the U.S., projected to create nearly a million new jobs in the next decade. But the growth isn’t without significant challenges, the Wall Street Journal reports.

The U.S. Department of Labor predicts the profession will grow by nearly 50% by 2022, the equivalent of close to a million new jobs. Though the expected growth is a positive sign for the industry, the sector may struggle to maintain a solid foothold, as high turnover and low wages plague the workforce.

Turnover for home health and personal care aides is around 40% to 65% each year, and their paychecks hover around $20,000, more than $5,000 below the other health care support occupations the Department of Labor tracks.

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One of the country’s biggest home care agencies, ResCare, hires about 2,000 new workers nationwide each month — but most of that is to replace workers who have left, Chief Executive Ralph Gronefeld Jr. tells the WSJ.

Recently, there has been movement in the home health care field, with proponents advocating for higher wages to reduce turnover. Yet those sentiments are met with opponents’ criticism that higher pay means a higher cost for the patient.

Starting next year, home health care workers employed by agencies or other third parties will be covered under the Fair Labor Standards Act, which guarantees the national minimum wage, currently at $7.25 an hour, and overtime protections.

Some states are fighting this rule, arguing that an increased cost of services would financially burden those who receive home-based services. Alternatively, home care workers are rallying for even more — a $15 minimum wage — to compensate them for a job they say is demanding.

The bulk of funding for the home health care industry — roughly 73%, or $44.3 billion — comes from government programs, primarily Medicaid and Medicare. But those programs may not be able to keep up with the influx in home care workers in the coming years or the pay increases many are hoping for.

Karen Kulp, president of Philadelphia-based HomeCare Associates, tells the WSJ that the industry is constrained by the state and federal Medicaid reimbursement system, which allows little wiggle room for pay. States determine rates for care, whether it is per visit or by the hour. But the payments must also cover an agency’s administrative staff, overhead costs and benefits.

So while the home health industry may experience positive growth within the decade, it will not be met without significant hurdles.

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